Electrocardiographic Assessment of Coronary Artery Disease and Stroke Risk Factors in Rural and Urban Tanzania: A Case–control Study

Authors

Richard W. Walker, Newcastle University, UK
Matthew Dewhurst, Newcastle University, UK
William K. Gray, yneside General Hospital, UK
Ahmed Jusabani, Aga Khan UniversityFollow
Eric Aris, Muhimbili University Hospital, Tanzania
Nigel Unwin, University of the West Indies, Barbados
Mark Swai, Kilimanjaro Christian Medical Centre,Tanzania
Philip C. Adams, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, UK
Ferdinand Mugusi, Muhimbili University College Hospital, Tanzania

Document Type

Article

Department

Imaging and Diagnostic Radiology (East Africa)

Abstract

Background

Although the association between cerebrovascular and coronary artery disease (CAD) is well known in high-income countries, this association is not well documented in black Africans. Aims The aim of this study was to document electrocardiographic (ECG) evidence of CAD in stroke cases and controls and to identify other common ECG abnormalities related to known stroke risk factors in a community-based population of incident stroke cases in Tanzania, East Africa.

Methods

This was a case–control study. Incident stroke cases were identified by the Tanzanian Stroke Incidence Project. Age- and sex-matched controls were randomly selected from the background population. Electrocardiograms were manually analyzed using the Minnesota Coding System, looking for evidence of previous myocardial infarction (MI), atrial fibrillation (AF) or atrial flutter (AFl), and left ventricular hypertrophy (LVH).

Results

In Hai, there were 93 cases and 241 controls with codable electrocardiograms, and in Dar-es-Salaam, there were 39 cases and 72 controls with codable electrocardiograms. Comparing cases and controls, there was a higher prevalence of MI and AF or AFl (but not LVH) in cases compared with controls.

Conclusions

This is the first published study of ECG assessment of CAD and other stroke risk factors in an incident population of stroke cases in sub-Saharan Africa. It suggests that concomitant CAD in black African stroke cases is more common than previously suggested.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Journal of Stroke and Cerebrovascular Diseases

Recommended Citation

Walker, R. W., Dewhurst, M., Gray, W. K., Jusabani, A., Aris, E., Unwin, N., ... & Mugusi, F. (2014). Electrocardiographic Assessment of Coronary Artery Disease and Stroke Risk Factors in Rural and Urban Tanzania: A Case–control Study. Journal of Stroke and Cerebrovascular Diseases, 23(2), 315-320.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.